certain cases one half of the body is implicated to a greater extent than the other. Along with these spasms (which however are not invariably present) we observe, as a general rule, a tremulousness of the muscles of the extremities and trunk, the patient, after a time, becomes by degrees more and more tranquil; the state of excitement passes into stupor and finally into deep coma; the pupils become large, react slowly with light, and the respiration becomes sighing, intermittent, and stertorous.

The pulse, which at first was slow, and continues so as long as the jaundice remains simple, at the outbreak of the nervous symptoms increases in frequency and gradually rises to 110 or 120, at the same time it presents remarkable variations as regards its frequency and volume.

The tongue and teeth are covered at an early period with a fuliginous crust-the abdomen is in most cases, but not always, tender upon pressure, especially in the hypochondriac regions. The extent of the hepatic dulness diminishes more and more as the disease advances, and not unfrequently the dull space disappears entirely; at the same time the spleen is increased in volume.

The bowels are almost always confined, and the stools are firm, dry, clay-like, deficient in bile, and at a later period not unfrequently dark colored and tarry from the presence of blood.

In the meantime the colour of the skin increases in intensity and numerous extravasations of blood take place into its tissue in the form of petechiae and more extensive ecchymoses, along with these there are

hæmorrhages from the vagina, the stomach and bowels and the bronchi.

The urine is more or less saturated with a brown coloring matter-presents the reaction of bile pigment, and deposits a light precipitate, in which with the microscope there may be detected, besides amorphous mucus, the epithelium of the urinary passages, and sometimes likewise of the kidneys, coloured yellow, and also needle-shaped crystals covered with colouring matter Sometimes the urine contains albumen.

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1.

MIDWIFERY.

Examiner.-A. PAYNE, M. D.

Comment on the following case, stating its nature, the physical cause of the symptoms, the appropriate treatment and probable termination.

Mrs. B. ætatis 34. Though she is only in the seventh month of her pregnancy, the abdomen is larger than it commonly is at the full term. The lower extremities are oedematous, she suffers much from constant severe pain in the hypogastrium, dyspnæa, and cough, the countenance is pale and anxious; the pulse quick and there is urgent thirst, with scanty secretion of urine. These symptoms have been experienced during the last three months; but the unusual enlargement of the abdomen was not perceived till the beginning of the seventh month of pregnancy, since which time it has been rapidly increasing. From the period of quickening, the movements of the foetus have been very feeble. An obscure fluctuation was felt in the abdomen-on

examining her vaginam, the os uteri was closed, but the cervix uteri was obliterated, as in the ninth month of pregnancy. The ballottement of the foetus was very distinct. Blood-letting, diuretics &c., were employed without relief. The difficulty of respiration became greatly aggravated, the abdomen still more distended, and the urine secreted in smaller quantity during the succeeding two weeks and on 21st October when the dyspnæa threatened suffocation, premature labour was induced. The placenta and foetal membranes though minutely examined, presented no trace of disease. The mother continued to suffer from dyspnæa and anasarca of the lower extremities for several weeks, but ultimately recovered. An obscure fluctuation in the abdomen was perceptible for some time after delivery. 2. Give in detail the symptoms, course, and treatment of a case of uterine hæmatocele, including its exciting causes and diagnostic signs.

3.

What are the most frequent disorders which are found to attend the decline of menstruation?

MENTAL AND MORAL SCIENCE.

Examiner.-S. B. PARTRIDGE.

1. What constitutes the distinction between Science and Art? Illustrate your answer by examples.

2. Enunciate your views with respect to the Materialistic Philosophy.

3. Explain the nature of the mental operation called imagination, and point out its beneficial influence on the character when exercised with due restraint.

4. Show the importance of a careful regulation of the will, and point out the principal means for the attainment of that end.

SURGERY.

Examiner.-J. FAYRER, M. D.

1. What are the diseases to which the bones of the extremities are liable after amputation through their continuity?

What constitutional and local symptoms do they give rise to; what points of Surgical and Pathological interest are, or may be, manifested in such cases, and what are the indications of treatment?

2. What are the earliest symptoms of disease of the hip-joint? and how are they explained physiologically and pathologically?

Trace the progress of a neglected case of ordinary hip-joint disease to its termination; and also give an account of the treatment, and your reasons for it, of a case coming under your care in the early stages of the disease.

3. Describe in detail, giving the anatomical relations of the parts exposed, the operation of ligature of the axillary artery immediately below the clavicle.

4. What are the conditions which give rise to the necessity of forming an artificial pupil? Describe them pathologically and surgically, giving an account of the operation most appropriate in each case.

5. What are the chief diseases of the Membrana Tympani? Describe their causes, symptoms and results.

L. M. S. Honor Examination.

SURGERY.

Examiner.-J. FAYRER, M. D.

1. What is epulis? Give an account of its pathology, its symptoms and treatment.

2. What are the morbid conditions to which the prostate gland is liable? Give a description of the causes, pathology, symptoms and treatment of each.

3. Describe the steps surgically, and anatomically of the operation of ligature of the lingual artery.

4. You have ascertained that a man has calculus in the bladder. What are the enquiries you would make as to his symptoms, and what pathological and surgical conditions would induce you to operate, or to decline operating?

5. A man has received a wound of the eye-ball; a small shot having entered the anterior chamber and lodged there. What would you do?

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